Medical errors and short staffing by hospitals: Is there a link?

Screen Shot 2015-03-05 at 11.29.25 AMA study by John Hopkins University says that hospital medical errors are the third-leading cause of death in the United States, with only heart disease and cancer killing more people annually. According to the study, more than 250,000 Americans are dying annually from medical mistakes in hospitals. That’s a population nearly the size of St. Paul, Minnesota.

“It boils down to people dying from the care that they receive rather than the disease for which they are seeking care,” said Martin Makary, a professor at the Johns Hopkins University School of Medicine who led the research.

What’s more, every year, hundreds of thousands of additional Americans are experiencing hospital medical mistakes that are dangerous, damaging, and life-altering. They’re living with preventable mistakes.

For nurses across the country and in Minnesota, the study echoes the clarion call nurses have been sounding at hospitals for years: Hospitals are cutting corners and not staffing enough nurses to meet the increased patient demand. Quality care is at risk. And some patients are dying.

From a recent story in Slate.

Hospital patients die when the number of patients under each nurse’s care rises above an established safe maximum (which varies according to how sick patients are). Linda Aiken at the University of Pennsylvania and Jack Needleman at the University of California in Los Angeles are two of the most prominent researchers who have—separately—documented a consistent correlation between decreases in nurse staffing in hospitals and subsequent increases in patient mortality.

Their work, along with research done by others, has transformed the phrase “safe staffing” from a slogan to a call to arms: When there aren’t enough nurses in hospitals, patients may die.

In addition, nurses say patient issues are becoming more complex, requiring the kind of care that was once reserved for Intensive Care Units.

Nurses in Washington were interviewed recently for a story about how changes in patient maladies and short staffing by hospitals is impacting care:

“Patients are coming in with not just one or two issues; it might be three or four. Or you’ve got an older population that is taking 15 to 20 medications that you’ve got to figure out what they’re taking for; if they’re contra-indicated,” meaning the drugs could have harmful interactions with each other.

And new requirements for documentation and electronic health records fall on nurses, too. Like doctors, nurses can end up spending more time in front of a computer screen than with patients.

When each nurse is responsible for five, six, eight patients at once, the time just gets eaten up.

“There’s been recent studies … in 60 minutes, the average nurse is spending 10 minutes with a patient,” Stephen-Selby said.

“Nurses oftentimes do not get a lunch break,” even though it’s legally required, she added, because there aren’t substitute nurses to cover for them: “If my colleague leaves, I now have 10 patients.”

Then if something happens to one of those patients, requiring the nurse’s full attention, “Those nine other patients are out there on their own,” she said.

In Minnesota, nurses say short staffing by hospitals is increasingly putting quality patient care at risk. In 2016, Minnesota nurses filed more Concern for Safe Staffing forms than any other year on record, citing incidents where patient care was compromised or at risk due to understaffing by hospitals.

“The staffing problem cannot be blamed on a nursing shortage,” said Mathew Keller, co-author of the analysis by the Minnesota Nurses Association. “Nursing schools are graduating two RNs for every new job opening in the state. Nurses simply are not being hired to fill needed positions.”

Learn more about why nurses in Minnesota are advocating for a Quality Patient Care Act to protect patient care in all Minnesota hospitals.

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Unsafe staffing costs a Florida facility $1 billion

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